Trastorno por Déficit de Atención/Hiperactividad (TDAH) y Trastorno de Tourette (TT): entre la comorbilidad y el diagnóstico diferencial / Attention deficit/hyperactivity disorder (ADHD) and To urette disorder (TD): between comorbidity and differential diagnosis

Resumen El Trastorno de Tourette (TT) y el Trastorno por déficit de atención / hiperactividad (TDAH) son entidades neu ropsiquiátricas que usualmente inician en la infancia. Esta revisión busca colaborar con los clínicos, quienes suelen confrontarse al dilema de saber si existe una comorbilidad o un diagnóstico diferencial, ya que esta pregunta cobra vital importancia en el momento de decidir el tratamiento. Invitamos al colega a revisar nuestros hallazgos, soportados por bases moleculares, fisiológicas y neuroanatómicas, además de los datos epidemiológicos. Al final, brindamos una propuesta de algoritmo diag nóstico que podrá utilizar cuando se encuentre ante síntomas compartidos entre los dos diagnósticos. El TDAH y el TT deben ser intervenidos tempranamente, para mejorar la calidad de vida y funcionalidad del paciente y prevenir secuelas, no solo en niños, niñas y adolescentes (NNA), también a lo largo de la vida.

Abstract Tourette Disorder (TD) and attention deficit hyperac tivity disorder (ADHD) are both major neuropsychiatric conditions that usually begin during infancy. This revision aims to collaborate with pediatricians, who are often confronted with the question of co-mor bidity or differential diagnosis between ADHD and TD. The question becomes urgent when the clinician must decide if he/she can start ADHD or TD treatment. We encourage our colleagues to revise our findings, based in bimolecular and neuroanatomic shared issues in ad dition to updated epidemiological findings. The clinician will find an original proposed algorithm that they can use when the shared symptoms are pres ent in a little patient. TD and ADHD must be intervened early, so we can get better outcomes. The consequences of letting the symptoms increase can generate sequels and handicaps, that can interfere with the quality of life and functionality not only during infancy and adoles cence but also in adult life.

Modelagem Molecular (TD-DFT) aplicada na predição do fator de proteção solar de compostos naturais / Molecular Modeling (TD-DFT) applied to predict the sun protection factor of natural compounds

Na área da saúde pública, as doenças provocadas pela radiação solar têm ganho grande destaque, por serem cada vez mais comuns. Dentre as principais formas de prevenção a utilização de filtros solares são as mais comuns e de fácil acesso. Os filtros utilizados atuam por sua capacidade de refletir, absorver ou dispersar os raios solares ultravioletas (UV). A aplicação de métodos teóricos tornou-se indispensável no auxílio do planejamento de novos compostos com função terapêutica, em estudos de suas diferentes propriedades, buscando gerar, manipular e analisar representações realistas de estruturas moleculares obtidas a partir de cálculos de propriedades físico-químicas por meio da química computacional. Neste estudo, foram selecionados compostos naturais de origem vegetal (3-O-metilquercetina, ácido gálico, aloína, catequina, quercetina e resveratrol), os quais são descritos com propriedades fotoprotetoras, para os quais se aplicou métodos computacionais para predição dos espectros de absorção, por meio do método TD-DFT (Teoria funcional da densidade dependente do tempo). Foram avaliadas as principais transições eletrônicas dos compostos estudados e se as diferenças de energia HOMO e LUMO para os compostos que absorvem na faixa UV compreendem na UVA (320400 nm, 3.103.87 eV), UVB (290320 nm, 3.874.27 eV) ou na UVC (100290 nm, 4.2712.4 eV). Realizou-se a validação experimental para o método aplicado para o EMC, quercetina e resveratrol, demonstrando a eficácia. Após os estudos realizados concluímos que o resveratrol, teoricamente é um ótimo candidato a fotoprotetor. O estudo ofereceu informações relevantes sobre o poder de predição in silico para fotoprotetores, e se utilizado pode contribuir diminuindo de tempo e custos em pesquisas para desenvolver fármacos

In the area of public health, diseases caused by solar radiation have gained great prominence, as they are increasingly common. Among the main ways to prevent the use of sunscreens are the most common and easily accessible. The filters used act by their ability to reflect, absorb or scatter the sun's ultraviolet (UV) rays. The application of theoretical methods has become indispensable in helping to plan new compounds with therapeutic function, in studies of their different properties, seeking to generate, manipulate and analyze realistic representations of molecular structures obtained from calculations of physicochemical properties through computational chemistry. In this study, natural compounds of plant origin (3-O-methylquercetin, gallic acid, aloin, catechin, quercetin, and resveratrol) were selected, which are described with photoprotective properties, for which computational methods were applied to predict the absorption spectra, using the TD-DFT (Time-Dependent Density Functional Theory) method. The main electronic transitions of the studied compounds were evaluated and whether the differences in HOMO and LUMO energy for compounds that absorb in the UV range comprise UVA (320400 nm, 3.103.87 eV), UVB (290 320 nm, 3.87 4.27 eV) or UVC (100290 nm, 4.2712.4 eV). Experimental validation was carried out for the method applied for CME, quercetin, and resveratrol, demonstrating its effectiveness. After the studies carried out, we concluded that resveratrol, theoretically, is an excellent candidate for sunscreen. The study provided relevant information about the in silico predictive power for photoprotectors, and if used, it can contribute to reducing time and costs in research to develop drugs

Research progress of thyroid dysfunctions during treatment with immune-checkpoint inhibitors / 中国临床药理学与治疗学

Thyroid dysfunction (TD) is one of the commonest endocrine immunotherapy-related adverse events (IRAEs) during cancer patients' treatment with immune checkpoint inhibitors (ICIs). In the hope that cooperation between departments will be enhanced to alleviate the side effect of immunotherapy which thyroid dysfunctions can cause, this review is contributed to make more endocrinologists and oncologists acknowledge and master clinical characteristics, diagnostic methods and therapeutic strategies of thyroid IRAEs, by the introduction of its pathogenesis, epidemiological features, diagnosis, treatment and prognosis.

Phytochemical, antioxidant investigations and fatty acid composition of Lepidium sativum seeds

Aim: The aim of the present study was to characterize Lepidium sativum seed for phytochemicals, fatty acid composition and antioxidant properties.Methodology: Extraction of phytochemicals in different solvents, estimation of phenolics and flavonoids, physio-chemical properties, antioxidant assay by DPPH method was carried out. Seed oil content was determined by modified cold percolation extraction method and TD-NMR, followed by fatty acid compositional analysis using GLC. Results: The perusal of data revealed that the total oil content varied from 21.36% to 24.38%, and the major fatty acids identified were linolenic acid (24.447%) followed by oleic acid (24.413%) and palmitic acid (12.278%) . Physio-chemical and phytochemical characteristics were estimated for useful functional properties and markers viz. alkaloids, sugar and proteins. L. sativum seeds exhibited high antioxidant potential (0.063mg ml-1) compared to standard compounds such as ascorbic acid, rutin and quercetin.

Epidemiology of Thyroid Dysfunction in Patients Evaluated By TFT at a Tertiary Care Lab in Central India

Background: Thyroid abnormality is the most commonendocrinological problem encountered in day to day practice.Clinicians request for thyroid tests in patients with presence orabsence of clinical features. Results of thyroid assessment aresuggestive of hypo or hyperthyroidism. The categories ofthyroid dysfunction are subclinical and overt disease.Materials & Methods: The study was carried out at SSIMScentral clinical lab- biochemistry section. The design of thestudy was retrospective. Serum samples of patients weretested within 1 hour of sample collection using CLIA CL-1000iimmunoassay.Results: Higher prevalence rates of TD were found amongpatients aged 21 and 44 (61.0%) followed by those between 45and 64 years 17.91% and 12.69% among those aged 15 yearsand below. The difference in the frequency of ThyroidDisorders among age groups is statistically significant(p<0.001). Shows the pattern of thyroid disease whenscreened with Thyroid stimulating Hormone (TSH), maximumbeing subclinical.Conclusion: Thyroid dysfunction is a fairly commonabnormality in clinical practice. The spectrum comprises ofprimary (overt) and subclinical conditions.

Re-emergence of diphtheria in Kerala: the need for change in vaccination policy

Background Diphtheria cases continue to occur in India despite a national vaccination program targeting the disease. Outbreaks of diphtheria have been known to occur in areas of low immunization coverage. An age shift has been noted to older children and adults in recent outbreaks from the Indian states of Andhra Pradesh, Karnataka, Delhi and Assam. Kerala witnessed its largest outbreak of Diphtheria in recent times from 2015 to 2017.Methods: Surveillance data from the Regional PEID Cell during the outbreak period was analysed and epidemiological data generated.Results: A total of 734 cases of diphtheria were reported during this period with eight deaths (Case fatality rate=1.08%). The mean age of the cases was 17.4 years (±13.9). More than 72% of the cases occurred in children above 10 year of age and 68% of the cases were either unimmunized or partially immunized. 32% of the cases were immunized for age. Of these, immunized children, 88% were above 10 years of age, indicating waning immunity with age. The existence of a sizeable unimmunized cohort in the adolescent age group and waning immunity among immunized were two major factors contributing to the outbreak.Conclusions: An age shift has been observed in the occurrence of Diphtheria cases during the outbreak in Kerala. Booster doses with Td vaccine during adolescence in addition to maintaining a high immunization coverage in the routine immunization program, with special emphasis on pockets of low coverage is essential for preventing the reemergence of diphtheria.

A Phase III Study to Evaluate the Immunogenicity and Safety of GC1107 (Adult Tetanus Diphtheria Vaccine) in Healthy Adults

BACKGROUND: This study was conducted to assess the immunogenicity and safety of GC1107 (adult tetanus diphtheria [Td] vaccine). The primary goal was to evaluate the non-inferiority of the immunogenicity of GC1107 compared to the control vaccine. Additionally, the safety profiles of GC1107 and the control vaccine were compared. METHODS: The subjects were adults ≥ 18 years old who were not injected with Td or adult tetanus-diphtheria-pertussis (TdaP) vaccine within the recent 5 years. A total of 253 subjects were enrolled and randomized to either the GC1107 group or the control group. For immunogenicity assessment, blood samples were collected at baseline and 28 days after vaccination and antibody titer of diphtheria and tetanus were assessed. RESULTS: The seroprotection rates of diphtheria and tetanus were 89.76% and 91.34%, respectively, in the GC1107 group, and 87.80% and 86.99% in the control group. The geometric mean titer (GMT) of the anti-diphtheria antibody increased after vaccination in both groups, showing no significant difference between the groups (P = 0.139). The anti-tetanus GMTs after vaccination also showed comparable increases in both groups, and showed no significant difference (P = 0.860). In the safety evaluation, solicited local adverse reactions occurred in 81.2% of the subjects in the GC1107 group and in 86.4% of the subjects in the control group. Solicited systemic adverse events occurred in 33.2% of the subjects in the GC1107 group and in 47.2% of the subjects in the control group, which did not reach statistical significance. CONCLUSION: This phase III study demonstrated non-inferiority in immunogenicity and comparable safety of GC1107 compared with the control Td vaccine. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02361866

Synthesis, characterization, X-ray crystal structure and DFT calculations of 4-([2,2':6',2 '' -terpyridin]-4'-yl)phenol / Síntesis, caracterización, estructura cristalina y cálculos DFT para el 4-([2,2':6',2 '' -terpiridin]-4'-il)fenol / Síntese, caracterização, estrutura de cristal e cálculos DFT para o 4-([2,2':6',2 '' -terpiridina]-4'-il)fenol

Abstract The synthesis of new terpyridine (Tpy) derivatives has been subject of extensive research due to its potential as functional materials for solar energy conversion, among other applications. In this contribution, the 4-([2,2':6',2"-terpyndm]-4'-yl)phenol (TpyOH) was synthesized, characterized and studied through several methods, including X-ray crystallography and computational approaches. Single crystal X-ray structure analysis shows that TpyOH is essentially planar, with dihedral angles of about 5.03° between the central pyridinyl and the phenolic ring, and also 6.05 and 12.2° in the terpyridine moiety. In the crystal, molecules are linked by intermolecular hydrogen bonds and through П- П stacking interactions. Using a time dependent density functional theory approach and taking into account bulk solvent effects, the absorption and fluorescence spectra of TpyOH were investigated and compared. The TD-DFT S0→Sn and S1 →S0 transition energies are in good agreement with experimental results. The frontier molecular orbitals analysis showed that the low-energy absorption band has an intraligand charge transfer character (ICT), while the high-energy band is a common feature of П- П* transitions of the Tpy moiety. The S1→S0 emission transition also has an ICT character, with a 90% contribution from the HOMO→LUMO transitions.

Resumen La síntesis de derivados terpiridinicos (Tpy) se ha investigado ampliamente debido a su potencial para la conversión de energía solar En este artículo se sintetizó y caracterizó el 4-([2,2':6',2"-terpiridin]-4'-il)fenol (TpyOH), a través de varias metodologías como la cristalografía de rayos X y herramientas computacionales. El análisis de rayos X de monocristal mostró que el TpyOH es plano, con ángulos diedros de 5,03° entre el piridinilo central y el anillo fenólico, con presencia de ángulos de 6,05 y 12,2° en la porción terpiridínica. En el cristal, las moléculas están unidas por enlaces de hidrógeno intermoleculares y mediante interacciones de apilamiento n-n. Utilizando cálculos DFT dependientes del tiempo (TD-DFT) y teniendo en cuenta el efecto de los disolventes, se investigaron y compararon los espectros de absorción y fluorescencia de TpyOH. Las energías de transición TD-DFT de S0→Sn y S1→S0 concuerdan con los resultados experimentales. El análisis de orbitales moleculares de frontera mostró que la banda de absorción de baja energía corresponde a transferencia de carga intraligando (ICT); mientras que la banda de alta energía es común en las transiciones П-П* del resto Tpy. La emisión debido a la transición S1→S0 corresponde a ICT, con una contribución del 90% proveniente de transiciones HOMO→LUMO.

Resumo A síntese de derivados de terpiridina (Tpy) tem sido estudada devido ao seu potencial para a conversão de energia solar. Nesta contribuição, o 4-([2,2':6',2"- terpindina]-4'-il) fenol (TpyOH) foi sintetizado, caracterizado e estudado por vários métodos A análise de estrutura de raios X de cristal único mostra que o TpyOH é plano, com Ångulos diedros de 5,03 ° entre o piridinilo central e o anel fenólico, e também 6,05 e 12,2 ° na porção de terpiridina No cristal, as moléculas são ligadas por ligações intermoleculares de hidrogênio e através de interações de empilhamento n-n. Usando uma abordagem da teoria funcional da densidade dependente do tempo e levando em consideração os efeitos do solvente em massa, foram investigados e comparados os espectros de absorção e fluorescência do TpyOH As energias de transição TD-DFT S0→Sn e S1→S0 estão de acordo com os resultados experimentais A análise de orbitários moleculares de fronteira mostrou que a banda de absorção de baixa energia possui um caráter de transferência de carga intraligando (TIC), enquanto a banda de alta energia é uma característica comum das transições П-П* da fração Tpy. A transição de emissão S1→S0 também tem um caráter TIC, com uma contribuição de 90% das transições HOMO→LUMO.

Vitaminas B1, B6, B12 e complexo B na prevenção da discinesia orofacial induzida porhaloperidol em ratos: avaliação comportamental e mecanismos associados

A Discinesia tardia (DT) é caracterizada por movimentos involuntários, principalmente na parte inferior da face, próximos da boca, com espasmos que podem ser leves ou severos. É uma alteração motora grave relacionada, mas não restrita à terapia antipsicótica. Tratamentos com antipsicóticos principalmente os da classe dos típicos, como o haloperidol (HAL) aumentam os riscos de DT. A fisiopatologia da DT é associada a um desequilíbrio em sistemas de neurotransmissão, dentre eles dopaminérgico e colinérgico, bem como com desequilíbrio oxidativo, principalmente em áreas cerebrais relacionadas ao controle do movimento, como o corpo estriado. As vitaminas (vit.) B, por sua vez, apresentam efeitos antioxidantes sendo cofatores para enzimas relacionadas à síntese de neurotransmissores. Neste contexto, o presente trabalho teve como objetivo determinar os efeitos preventivos das vit. B1, B6, B12 ou Complexo B na discinesia orofacial (DO) induzida por HAL em ratos. Foram utilizados ratos Wistar machos tratados por via intraperitoneal com HAL (1 mg/kg, i.p.) por 21 dias ou concomitantemente com HAL e as vit. B1 (60 mg/kg), B6 (60 mg/kg) ou B12 (0,6 mg/kg) por via subcutânea, sozinhas ou em associação (complexo B). O complexo B consistiu na mistura das 3 vitaminas em iguais proporções. Um grupo de animais foi administrado clozapina (25 mg/kg), um antipsicótico atípico não relacionado ao desenvolvimento de DO. Os testes comportamentais foram realizados após 30 minutos no 1º, 7º e 21º dias de administração das fármacos e consistiram na determinação da atividade locomotora, catalepsia e movimentos de mastigação no vazio...

Tardive dyskinesia (TD) is characterized by involuntary movements, mostly at lower face, near the mouth, with convulsion that can be light or hard. Is one severe disorder related, but restricted the antipsychotic therapy. Antipsychotic treatments above all the class of typical, like haloperidol (HAL) increase the risk of TD. The pathophysiology of TD is associated to a instability in neurotransmission system, such as dopaminergic and cholinergic, among others, as well as with oxidative instability mainly in brain areas related to the control of movement, as the striatum. B vitamins, in turn, show antioxidants effect and are cofactors to enzymes related to the synthesis of neurotransmitters. In this context, the present study aimed to determine the preventive effects of B1, B6, B12 vitamins or B complex against orofacial dyskinesia (OD) induced by HAL in rats. To do this male Wistar rats were intraperitoneally administered HAL (1 mg/kg, i.p.) for 21 days or concomitantly received HAL, B1 (60 mg/kg), B6 (60 mg/kg) or B12 (0,6 mg/kg) vitamin subcutaneously alone or in association. B complex consisted in the mix of 3 vitamins in equal proportions. One group of animals was administered with clozapine (25 mg/kg), an atypical antipsychotic not related to the development of OD. Behavioral tests were performed at the 1st, 7th and 21st days of drugs administration. The behavioral tests performed were locomotor activity, catalepsy and chewing vacuous movements. At 21stday the animals were sacrificed and had their brain areas dissected for neurochemical analysis. The results showed that HAL increased catalepsy time at 7th day and OD at 21stday...

Differential expression of speckled POZ protein, SPOP: Putative regulation by miR-145.

The speckle POZ protein, SPOP, is an adaptor of the Cul3-based ubiquitination process, and has been implicated in the carcinogenesis process. Despite recent elucidation of biological functions, regulation of SPOP gene expression has not been reported. In this study, the mRNA levels of the mouse SPOP (mSPOP) gene were first shown to vary noticeably in different tissues. However, the SPOP protein was detected in high abundance only in Purkinje cells of the cerebellum and seminiferous tubule of the testis, echoing previous reports of involvement of ubiquitination in neuron cells and in spermatogenesis. In other mouse tissues and human cancer cell lines analysed, only low SPOP protein levels were detected. The 3′-untranslated regions of both the mSPOP and human SPOP transcripts harbor a conserved putative miR-145 binding site (BS). In some tissues and cell lines, miR-145 and SPOP protein levels were in an inverse relationship suggesting miR-145 regulation. Luciferase assays of deletion and point mutation constructs of the miR-145 BS, and miR-145 induction by serum starvation that resulted in reduced endogenous SPOP levels provided further evidence that miR-145 is likely involved in post-transcriptional regulation of SPOP expression in selected tissues, and possibly with the participation of other miRNA species.

Differential expression of speckled POZ protein, SPOP: Putative regulation by miR-145.

The speckle POZ protein, SPOP, is an adaptor of the Cul3-based ubiquitination process, and has been implicated in the carcinogenesis process. Despite recent elucidation of biological functions, regulation of SPOP gene expression has not been reported. In this study, the mRNA levels of the mouse SPOP (mSPOP) gene were first shown to vary noticeably in different tissues. However, the SPOP protein was detected in high abundance only in Purkinje cells of the cerebellum and seminiferous tubule of the testis, echoing previous reports of involvement of ubiquitination in neuron cells and in spermatogenesis. In other mouse tissues and human cancer cell lines analysed, only low SPOP protein levels were detected. The 3′-untranslated regions of both the mSPOP and human SPOP transcripts harbor a conserved putative miR-145 binding site (BS). In some tissues and cell lines, miR-145 and SPOP protein levels were in an inverse relationship suggesting miR-145 regulation. Luciferase assays of deletion and point mutation constructs of the miR-145 BS, and miR-145 induction by serum starvation that resulted in reduced endogenous SPOP levels provided further evidence that miR-145 is likely involved in post-transcriptional regulation of SPOP expression in selected tissues, and possibly with the participation of other miRNA species.

Predictive Value of Ventricular Transmural Dispersion of Repolarization on Rapid Ventricular Tachycardia Risk in Patients After Resynchronization / 中国循环杂志

Objective: Cardiac resynchronization therapy defibrillator (CRT-D) increases ventricular transmural dispersion of repolarization (TDR). Our work evaluated the relationship between QTc interval of TDR indicators, TpTe, TpTe/QTc ratio and rapid ventricular arrhythmia in patients with CRT-D. Methods: A total of 160 consecutive patients who received CRT-D implantation in our hospital from 2011-01 to 2013-03 were studied. The immediate post operative ECG was collected to analyze lead V5 QTc interval, TpTe and TpTe/QTc ratio for assessing its TDR. The patients were divided into 2 groups: Treatment group, the patients with ventricular tachycardia or ventricular ifbrillation received CRT-D,n=30 (18.7%) and Non-treatments group,n=130 (81.3%). All patients were followed-up for (20 ± 10) months and the rapid ventricular arrhythmia was recorded by CRT-D devices. Results: The patients in Treatment group had increased TpTe/QTc (0.24 ± 0.05) vs (0.20 ± 0.04, and TpTe (119 ± 30) ms vs (95 ± 20) ms, bothP<0.001. The QTc interval was similar between 2 groups (480 ± 60) ms vs (470 ± 70) ms,P=0.6 and QTc interval was not related to the risk of CRT-D requirement. The sensitivity and speciifcity for TpTe/QTc ≥ 0.25 predicting the risk of ventricular arrhythmia in CRT-D patients were at 47% and 91%, while TpTe ≥ 120 ms were at 40% and 95%respectively. The post CRT-D surviving curve analysis indicated that TpTe/QTc ratio and TpTe could predict the prognosis in relevant patients,P<0.001. Conclusion: The elevated TpTe and TpTe/QT ratio may increase the incidence of CRT-D requirement in patients with ventricular arrhythmia after resynchronization.

Evaluation of Immunogenicity and Safety of the New Tetanus-Reduced Diphtheria (Td) Vaccines (GC1107) in Healthy Korean Adolescents: A Phase II, Double-Blind, Randomized, Multicenter Clinical Trial

This phase II clinical trial was conducted to compare the immunogenicity and safety of a newly developed tetanus-reduced diphtheria (Td) vaccine (GC1107-T5.0 and GC1107-T7.5) and control vaccine. This study was also performed to select the proper dose of tetanus toxoid in the new Td vaccines. Healthy adolescents aged between 11 and 12 yr participated in this study. A total of 130 subjects (44 GC1107-T5.0, 42 GC1107-T7.5 and 44 control vaccine) completed a single dose of vaccination. Blood samples were collected from the subjects before and 4 weeks after the vaccination. In this study, all subjects (100%) in both GC1107-T5.0 and GC1107-T7.5 groups showed seroprotective antibody levels (> or = 0.1 U/mL) against diphtheria or tetanus toxoids. After the vaccination, the geometric mean titer (GMT) against diphtheria was significantly higher in Group GC1107-T5.0 (6.53) and GC1107-T7.5 (6.11) than in the control group (3.96). The GMT against tetanus was 18.6 in Group GC1107-T5.0, 19.94 in GC1107-T7.5 and 19.01 in the control group after the vaccination. In this study, the rates of local adverse reactions were 67.3% and 59.1% in GC1107-T5.0 and GC1107-7.5, respectively. No significant differences in the number of adverse reactions, prevalence and degree of severity of the solicited and unsolicited adverse reactions were observed among the three groups. Thus, both newly developed Td vaccines appear to be safe and show good immunogenicity. GC1107-T5.0, which contains relatively small amounts of tetanus toxoid, has been selected for a phase III clinical trial.

Aplicación de la teledermatología asincrónica en usuarios de la comuna de Yerbas Buenas, Región del Maule, Chile / Effectiveness of asynchronous teledermatology in users of the rural health center in Chile

La teledermatología (TD) revoluciona la atención en dermatología, facilitando su acceso a regiones remotas. La TD asincrónica (TDA), utilizada para el diagnóstico dermatológico a través del envío de información mediante e-mail, ha sido implementada en forma limitada en Chile. El objetivo de este estudio fue analizar la efectividad y la satisfacción usuaria (SU) de la TDA en un centro de salud rural de Chile. Se diseño un sistema de teleconsultas, capacitando a los médicos generales en patología dermatológica más frecuente y se realizó contrarreferencia. Se analizaron 172 teleconsultas. Las patologías más frecuentes fueron: acné (11,1 por ciento), onicomicosis (8,7 por ciento), psoriasis (4,1 por ciento), dermatitis de contacto (4,1 por ciento) y verrugas (4,1 por ciento), Se encontró alta concordancia diagnóstica (CD) entre médicos generales y especialista (88,3 por ciento). La SU general alcanzó un 97 por ciento y se logró la resolución del 99,4 por ciento de las teleconsultas. La TDA permite proporcionar atención dermatológica a distancia, lo que permitiría favorecer a diversas localidades rurales de Chile.

Teledermatology (TD) revolutionizes the delivery of dermatology services by facilitating the access to specialist services at a distance. Asynchronous TD (ATD) is used for skin diseases diagnosis by sending information and images through e-mail. Its implementation in Chile has been limited. The purpose of this study was to analize the effectiveness and the user satisfaction (US) of the application of ATD in a rural helath center in Chile. A teleconsultation system was designed, primary care general practitioners were trained in dermatological diagnosis and implementation of the cross-refertence was developed. We assessed 172 teleconsultations. The most frequent pathologies were acne (11,1 percent), onychomycosis (8,7 percent), psoriasis (4,1 percent), contact dermatitis (4,1 percent) and warts (4,1 percent). The diagnosis concordance (DC) was 88,3 percent and the general US reached 97 percent. Diagnostic and therapeutic resolution was achieved in 99,4 percent of the teleconsultations. ATD was able to provide a distant dermatological assistance, helping several rural areas of Chile.

Attention characteristics of children with comorbid attention deficit hyperactivity disorder and tic disorder / 中华行为医学与脑科学杂志

Objective To investigate the characteristics of attention in children with comorbid attention deficit hyperactivity disorder (ADHD) and tic disorder (TD) (CAT). Methods 60 children with comorbid ADHD and TD (CAT), 79 children with ADHD, 60 children with TD and 71 normal control children (NG) were collected. All of those cases were evaluated with the integrated visual and auditory continuous performance test (IVA-CPT). Results It was slightly higher for visual response control quotient (VRCQ) in CAT group(85.15 ±21.10) than those in ADHD group(78.52 ± 21.85) (P ＜ 0.05), there was no significant different in the other five scores between CAT group and ADHD group (P＞0.05). It was significantly lower for the full response control quotient (FRCQ), auditory response control quotient (ARCQ) ,visual response control quotient (VRCQ), full attention quotient (FAQ), auditory attention quotient (AAQ) and visual attention Quotient (VAQ) in CAT group (83.43 ± 20.98,86.12 ± 19.88,85.15 ± 21. 10,64.88 ± 16.88,67.92 ± 17. 11 ,67.97 ± 20.04) than those in TD group(96.47 ± 17.83,97.50 ± 17.62,95.72 ± 18.87,85.37 ± 18.54,86.47 ± 17.32,87.43 ± 19.89) and those in normal control group(98.42 ± 12.67,101.50 ± 15.39,95.92 ± 11.79,99.33 ± 12.98,98.50 ± 12.09,100.00 ± 16.12) (P＜0.01). Conclusion There have serious reduced control ability and attention deficit in children with CAT. The attention deficit is attributed to the existence of ADHD.

The Need of Td Vaccination According to the Changes of Tetanus and Diphtheria Immunity

The incidences of diphtheria and tetanus have been markedly reduced by the worldwide use of DTP vaccines. In Korea, tetanus outbreaks have disappeared since 1980s, and there has been no report on a patient with diphtheria since 1987. However, tetanus is still one of major health problems in many developing countries, and several serosurveillance studies in developed countries revealed that a substantial proportion of adult population may lack immunity against tetanus, and the immunity level against tetanus is continuously decreasing by age. In fact, few patients with tetanus have been reported since 1990s, and the immunity to tetanus is dramatically decreased in age groups over 30 years in our country. Also, persistent outbreaks of diphtheria in developing and developed countries have been reported. Many studies indicate that diphtheria outbreaks may occur under circumstances of ineffective immunization. In Korea, a few studies have reported that the diphtheria antibody titers in the 20~50 year age groups sharply decreased. Many studies confirmed that vaccine-induced immunity against tetanus and diphtheria did not last throughout the life, and serosurveillance studies suggested the existence of a large pool of susceptible individuals with a potential for epidemic infection. These results indicate that the Td vaccination program in adolescents and adults should be considered for maintenance of tetanus and diphtheria immunity.

Theoretical study on the electronic structures and spectral properties of ebselen and its carboxylic derivatives / 重庆医科大学学报

Objective:To investigate the electronic structures,spectral properties of ebselen and its carboxylic derivatives and their relationship.Methods:Ebselen and its carboxylic derivatives were optimized by using density functional theory at the B3LYP/6-31+G level,the characteristics of the frontier molecular orbital and the distribution of energy levels were analyzed.Time depended density function theory methods were employed to calculated electronic structure and spectral properties of ebselen and its carboxylic derivatives. Results:There is an angle between benzisoselenazol ring and benzene ring;the absorption spectra mainly originates from the?→? electronic transition.Conclusion:The carboxyl in o-position of benzene ring may increase the dihedral angle between benzisoselenazol ring and benzene ring,and causes a red shift of UV spectra.

Adult Immunization

In 1796, Jenner inoculated the vesicular fluid from cowpox lesions into the skin of susceptible individuals and induced protection against smallpox, and thus the era of immunization began. With the introduction of vaccinations, children and adults are now protected against 15 life-threatening or debilitating diseases. In 1980, the WHO declared that smallpox was eradicated and people did not need to be vaccinated any more. Vaccines have reduced cases of all vaccine-preventable diseases by more than 97% from peak levels before vaccines were available. Despite these success stories and even though coverage has improved, pockets of under-immunized children remain, leaving the potential for outbreaks. Many adolescents and adults are under-immunized as well, missing opportunities to protect themselves against vaccinepreventable diseases such as tetanus, hepatitis B, influenza, and pneumococcal disease. In the text, we intend to describe the indication, adverse effects, and contraindications of adult immunization.

The application of TD (Touch-Down) PCR in Diagnosis of leprosy and Detection of MDT-resistant M. leprae / 나학회지

There are several methods for diagnosis of leprosy, including AFB stain, the measurement of PGL-1 (phenolic glycolipid - 1) antigen titer, and DNA-PCR. In this study, we have used the DNA-PCR amplifying the RLEP repetitive sequence. Our result showed that the RLEP primer offered the more sensitive detection and identification of M. leprae DNA in clinical specimens, compared with the other primer, for example, 18-kDa antigen gene. To screen the resistant M. leprae strain of MDT (Multi-Drug Therapy), we have used the TD (Touch-Down) PCR. We arranged and amplified sequences of the genes, folP, rpoB, gyr, 23S rRNA, in M. leprae involved in MDT-resistance, and could obtain the PCR product each gene, simultaneously. This method, based on annealing temperature, was useful to the detection for diagnosis and the screen of MDT-resistant strain of M. leprae, rapidly. Thus, we suggest that the RLEP primer and TD-PCR method are effective in assessing the diagnosis of leprosy and the identification of drug-resistant M. leprae.

The TD-PCR and Phylogenetic Analysis of Bacillus licheniformis 16S rDNA / 微生物学通报

16S rDNA sequences of 30 Bacillus strains originally identified as Bacillus licheniformis from China Center of Industrial Culture Collection (CICC) were determined and analyzed. The results indicated that 24 strains are affiliated to Bacillus licheniformis;3 strains are affiliated to Bacillus cereus and 1 strain is affiliated to Bacillus subitilis;the similarity levels of 16S rDNA among the rest of 2 strains and other strains of Bacillus licheniformis,range from 96.4% to 97.4%,further tests are needed to clarify their position. Also we testified that 5' terminal 500bp of 16S rDNA is available to differentiate the strains of Bacillus licheniformis、Bacillus subtilis and Bacillus cereus.